We assess the severity and frequency of diabetic ketoacidosis (DKA) in new-onset type 1 diabetes mellitus (T1D) patients and in patients with previous diagnosis of T1D in a referral Brazilian university hospital in the first five months of the COVID-19 pandemic. We also compare the data with data from pre-pandemic periods. Forty-three new-onset T1D patients were diagnosed between April and August of the years 2017, 2018, 2019, and 2020. During the COVID-19 pandemic, the number of newonset T1D was over twice the number of new-onset T1D in the same period in the three previous years. All the 43 patients survived and are now on outpatient follow-up. We also compared the characteristics of the T1D patients hospitalized between April and August of the years 2017, 2018, and 2019 (32 hospitalizations) to the characteristics of the T1D patients hospitalized between April and August/2020 (35 hospitalizations; 1 patient was hospitalized twice in this period). Fourteen of the 34 patients admitted during the pandemic presented with COVID-19-related symptoms (any respiratory symptom, fever, nausea, vomiting, and diarrhea), but only one had positive SARS-CoV-2 RT-PCR test. Samples from 32 out of these 34 patients were assayed for SARS-CoV-2 antibodies, and four patients were positive for total antibodies (IgM and IgG). In agreement with recent reports from European countries, we observed increased frequency of DKA and severe DKA in new-onset and previously diagnosed T1D children and adolescents in a large referral public hospital in Brazil in the first five months of the COVID-19 pandemic. The reasons for this outcome might have been fear of SARS-CoV-2 infection in emergency settings, the more limited availability of primary healthcare, and the lack of school personnel's attention toward children's general well-being.
Background: The SARS-CoV-2 pandemic expanded rapidly around the world in 2020 and health services needed to be reconfigured to meet the new demand and ensure the care of patients with chronic diseases, whether or not aggravated by this COVID-19 (disease caused by SARS-Cov-2). For patients with chronic diseases - such as diabetes mellitus - the teleconsultation stood out as a tool for clinical management in this period. This study aims to evaluate the impact of teleconsultation on glycemic control and prevention of acute complications related to diabetes mellitus in children and adolescents treated by the pediatric endocrinology team at Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo (HC-FMRP -USP) during the COVID-19 pandemic in 2020. Method: Descriptive study of data from pediatric diabetic patients who received teleconsultation via messages in the months of April to September 2020. Results: Regarding the patients evaluated (N = 143), there were 3.4 teleconsultations per patient in the studied period; requiring adjustment of insulin doses in 84.6% of cases. The hospital admission rate was 17.5% due to diabetic decompensation and / or the opening of diabetes mellitus. The dosage of glycosylated hemoglobin showed a worsening in 46% of the sample and an improvement in 37%. Conclusion: The teleconsultation was effective in ensuring health care for patients with DM1 during the COVID-19 pandemic.
Introduction: The SARS-CoV-2 pandemic expanded rapidly around the world in 2020 and health services needed to be reconfigured to meet the new demand and ensure the care of patients with chronic diseases. For patients with diabetes mellitus, the teleconsultation stood out as a tool for clinical management in this period. Objective: Evaluate the impact of teleconsultation on glycemic control and prevention of acute complications related to diabetes mellitus in children and adolescents treated in a reference hospital during the COVID-19 pandemic in 2020. Method: Descriptive study of data from pediatric diabetic patients who received teleconsultation between April and September 2020. Results: During this period, 143 diabetic patients were evaluated, with a median of 3.4 teleconsultations per patient in the studied period; requiring adjustment of insulin doses in 84.6% of cases. The hospital admission rate was 8,4% due to diabetic decompensation. The metabolic control (HbA1c) became worsen in 46% of the sample and improved in 37%. Conclusion: The teleconsultation promoted health care for patients with diabetes mellitus during the COVID-19 pandemic, but was not able to guarantee adequate glycemic control.
Mesmo entre os especialistas mais dedicados, a prática clínica da Neuroendocrinologia é conhecida por sua larga complexidade. Os temas e subtemas a partir dos quais se pode dividir a especialidade são inúmeros e precisam ser tratados com o devido cuidado, assegurando aos profissionais médicos referências confiáveis para as abordagens e aplicações mais adequadas em sua rotina. O Guia Prático em Neuroendocrinologia é o resultado da reunião dos principais nomes da área e uma iniciativa do Departamento de Neuroendocrinologia da Sociedade Brasileira de Endocrinologia e Metabologia (SBEM). Em 28 capítulos escritos em uma linguagem acessível, o guia oferece uma literatura que, ao assimilar a complexidade da Neuroendocrinologia, enfoca as lacunas de conhecimento de endocrinologistas de todo o país, visando transformá-las em informações consistentes e atualizadas para o melhor atendimento dos pacientes.
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